Fact Sheet
Will Adoption of Electronic Health Records Improve Quality
in U.S. Hospitals?
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T
he Health Information Technology for Economic and Clinical Health Act of 2009 includes funds
to stimulate adoption of health information technology, particularly electronic health records
(EHRs), reflecting the general consensus that widespread adoption of information technology will
increase efficiency and improve patient care. Approximately $30 billion in Medicare and Medicaid
incentives will be paid out over the life of the program, mostly to hospitals that can demonstrate “meaningful use” of a “certified” EHR.
Will installing a new EHR, or improving the capabilities of an existing one, improve quality over
time? To answer this question, RAND researchers integrated extensive data from 2003 and 2006 on EHR
adoption, hospital characteristics, and hospital quality in nearly 2,100 hospitals. They examined how
EHRs affected 17 measures of hospital process quality across three common clinical conditions: acute
myocardial infarction (AMI), heart failure, and pneumonia. EHRs were placed in tiers depending on their
capabilities; top-tier hospitals were those with an operational computerized provider order entry system
(an advanced EHR), because such a system facilitates decision support where care is being provided. Study
findings provide the following insights about the potential effects of EHRs on health care quality:
■Quality
of care for AMI, heart failure, and pneumonia improved broadly during the period studied.
■But
quality scores for heart failure processes improved significantly more in hospitals with basic EHRs
than in those without them.
■However,
newly adopting a basic EHR did not significantly affect quality improvement.
■Indeed,
quality scores for AMI and heart failure improved less in hospitals that had newly adopted or
upgraded to an advanced EHR, compared with hospitals that maintained the status quo.
■“Ceiling
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effects” may limit the usefulness of existing measures of hospital quality for assessing EHR
effects. For example, average quality ratings for AMI and pneumonia are already high, and additional
improvement may be challenging.
Better metrics for assessing what constitutes meaningful use should help to identify which elements
of EHRs have the greatest effect on quality of care.
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© RAND 2011
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This fact sheet is based on Jones SS, Adams JL, Schneider EC, Ringel JS, and McGlynn EA, “Electronic Health Record Adoption and Quality Improvement in US Hospitals,” American Journal of Managed Care, Vol. 16, No. 12, Health Information
Technology Special Issue, December 2010, pp. SP64–SP71 (EP-201000-136, http://www.rand.org/pubs/
external_publications/EP201000136.html).
This fact sheet was written by Mary E. Vaiana. The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis.
RAND’s publications do not necessarily reflect the opinions of its research clients and sponsors. R® is a registered trademark.
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RB-9570 (2011)
CHILDREN AND FAMILIES
EDUCATION AND THE ARTS
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